Prevalence of multidrug-resistance and blaVIM and blaIMP genes among gram-negative clinical isolates in tertiary care hospital, Kathmandu, Nepal

Background and Objectives: Carbapenems have been the choice of antibiotics for the treatment of infections caused by multidrug-resistant bacteria. The main objective of this study was to determine the prevalence of carbapenemase (blaVIM and blaIMP) producing isolates among Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Materials and Methods: A total of 1,151 clinical samples were collected from the patients visiting Annapurna Neurological Institute and Allied Science and Annapurna Research Centre, Kathmandu, between June 2017 and January 2018. Antibiotic susceptibility testing (AST) was performed on the Enterobacteriaceae, P. aeruginosa and A. baumannii isolates using the Kirby-Bauer disk diffusion method. The modified Hodge test (MHT) was performed on the carbapenem-resistant isolates to confirm carbapenemase production. DNA was extracted and then screened for blaVIM and blaIMP genes by multiplex PCR. Results: Of the total 1,151 clinical samples, 253 (22.0%) showed positive growth. Of them, 226 (89.3%) were identified as Enterobacteriaceae, P. aeruginosa, and A. baumannii. Among the 226 isolates, 106 (46.9%) were multidrug-resistant. Out of the 106, 97 (91.5%) isolates showed resistance to at least one of the carbapenem used. Among the 97 carbapenem-resistant isolates, 67 (69.1%) showed the modified Hodge test (MHT) positive results. blaVIM and blaIMP were detected in 40 and 38 isolates respectively using multiplex PCR assay. Conclusion: This study determined a high prevalence of MDR and carbapenem resistance among Enterobacteriaceae, P. aeruginosa, and A. baumannii as detected by the presence of blaVIM and blaIMP genes. This study recommends the use of rapid and advanced diagnostic tools along with conventional phenotypic detection methods in the clinical settings for early detection and management of drug-resistant pathogens to improve treatment strategies

Wildlife assessment of the Chandragiri hills, Kathmandu: Potentiality for ecotourism

Wildlife assessments can provide crucial information regarding species richness, relative abundance and spatial, temporal, and ecological information on wildlife habitat associations. The assessment’s information can in turn be used for developing management policies including for establishing touristic zones. We investigated wildlife occurrences in the Chandragiri Hills, Kathmandu Nepal from 2015-2019 to provide baseline data to inform the potential sites for ecotourism. During the study period, we recorded 30 mammal species, 199 bird species, 34 herpetofauna species and 77 butterfly species. The area harbors three globally and six nationally threatened mammal species, two globally and seven nationally threatened with one endemic bird species, one globally and nationally threatened herpetofauna, and one nationally threatened butterfly species. We also explored four potential hiking routes for observing wildlife and providing scenic views of the Himalayan range and Kathmandu city. Therefore, we expect Chandragiri Hills can become one of the hot spot for tourists to observe both common and threatened wildlife species in Nepal

Diarrheal disease outbreak in Gaidatar village of Rautahat District, Nepal

Abstract Objective Diarrheal diseases, including cholera, remain a major public health concern in developing countries like Nepal. This study investigated a diarrheal outbreak that affected over 1500 people in Gaidatar village of Rautahat district in central Nepal and sought to identify the source and causation of the disease. Stool samples were collected from individuals with acute diarrheal illness (n = 16) and healthy non-diarrheal children (n = 39), along with samples from local drinking water sources (n = 8) and their sewage system (n = 10). None of the individuals were sampled multiple times. Diarrheic stool and sewage samples were analysed for the presence of Vibrio cholerae, while coliforms were tested in drinking water samples following standard microbiological protocols. Enteric parasites were tested in both diarrheic and non-diarrheic stool samples. Results Vibrio cholerae O1 Ogawa serotype was isolated in 18.7% of the diarrheic stool and 20.0% of the sewage. Coliforms were found in all drinking water samples, with 87.5% testing positive for fecal coliform. Additionally, 43.6% of the stool samples (n = 55) had at least one of the intestinal parasites tested, primarily Giardia lamblia (21.8%). However, almost all parasites were found in non-diarrheal stool. Taken together, our results provide evidence that the diarrheal outbreak was associated with V. cholerae O1 Ogawa serotype, possibly transmitted through the drinking water sources contaminated with fecal matters from their sewage (drainage) system. These findings warrant regular surveillance of drinking water sources to help prevent future outbreaks

Additional file 1 of Phenotypic detection of methicillin resistance, biofilm production, and inducible clindamycin resistance in Staphylococcus aureus clinical isolates in Kathmandu, Nepal

Additional file 1: Photograph S1. (A) Isolation of S. aureus in blood agar, (B) Identification of S. aureus using DNase media. S. aureus showing a clear zone around the colonies, (C) Antibiotic sensitivity test of S. aureus, (D) D-test: Flattening of Clindamycin adjacent to Erythromycin at a distance of 15 mm shows ICR. (E) Biofilm detection by Tissue culture plate method: Microtitre plate showing different levels of biofilm production, (F) Determination of MIC of Vancomycin by E-test method

Functional Involvement of circRNAs in the Innate Immune Responses to Viral Infection

Effective viral clearance requires fine-tuned immune responses to minimize undesirable inflammatory responses. Circular RNAs (circRNAs) are a class of non-coding RNAs that are abundant and highly stable, formed by backsplicing pre-mRNAs, and expressed ubiquitously in eukaryotic cells, emerging as critical regulators of a plethora of signaling pathways. Recent progress in high-throughput sequencing has enabled a better understanding of the physiological and pathophysiological functions of circRNAs, overcoming the obstacle of the sequence overlap between circRNAs and their linear cognate mRNAs. Some viruses also encode circRNAs implicated in viral replication or disease progression. There is increasing evidence that viral infections dysregulate circRNA expression and that the altered expression of circRNAs is critical in regulating viral infection and replication. circRNAs were shown to regulate gene expression via microRNA and protein sponging or via encoding small polypeptides. Recent studies have also highlighted the potential role of circRNAs as promising diagnostic and prognostic biomarkers, RNA vaccines and antiviral therapy candidates due to their higher stability and lower immunogenicity. This review presents an up-to-date summary of the mechanistic involvement of circRNAs in innate immunity against viral infections, the current understanding of their regulatory roles, and the suggested applications

Prevalence, antimicrobial susceptibility pattern and multidrug resistance of methicillin-resistant Staphylococcus aureus isolated from clinical samples at a tertiary care teaching hospital: an observational, cross-sectional study from the Himalayan country, Nepal

Objective We sought to determine the prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the clinical samples at a tertiary care hospital in Nepal.Methods Cross-sectional, observational study design.Study setting The study was carried out at a tertiary care facility, the largest public hospital, Tribhuvan University Teaching Hospital (TUTH), Nepal.Participants A total of 7433 clinical samples from hospital inpatients and outpatients available in the TUTH microbiology laboratory were examined. The study included clinical samples from the patients of either sex and across all age groups that had been clinically determined to have S. aureus infections.Results Of 7433 clinical samples analysed, S. aureus was recovered from 499 (6.71%). The prevalence of MRSA was discovered to be 26.4% (95% CI 21.6% to 30.4%). The major sources of MRSA were pus, 71 (18.5%). MRSA isolates encountered 100% resistance to penicillin and cloxacillin, followed by ciprofloxacin (80.5%), erythromycin (79.8%), cephalexin (64.9%), cotrimoxazole (61.1%) and clindamycin (58.5%). Chloramphenicol (17.9%), and gentamicin (27.4%), on the other hand, exhibited minimal resistance. None of the isolates were resistant to vancomycin (0.0%). Prevalence of multidrug resistance (MDR) was markedly higher in MRSA, 94.05% (95% CI 89.4% to 98.6%), compared with methicillin-sensitive S. aureus, 52.12% (95% CI 46.2% to 57.8%).Conclusion Our study indicated a high rate of MRSA and MDR-SA (Multidrug-resistant Staphylococcus aureus) prevalence in a Nepalese tertiary care hospital. Therefore, given the widespread burden of MRSA and the threat of the emergence of resistance to commonly used antibiotics, there is a need for the development, adoption and enforcement of appropriate control policies in these hospital settings. Regular surveillance, reporting mechanism as well as prudent use of antimicrobial agents are crucial to combating the progression of MDR-MRSA prevalence and antibiotic resistance